Correlation of remnant cholesterol with non-culprit coronary lesions and its prognosis in patients with acute coronary Syndrome
YANG Hong
LIU Sen
SHAO Qi-qi
WEI Meng-wei
LIU Zi-yang
JIN Meng-long
FU Zhen-yan
Abstract：Objective To investigate the correlation of remnant cholesterol(RC)with the progression and major adverse cardiovascular events(MACE)of non-culprit coronary lesions(NCCLs)in patients with acute coronary syndrome(ACS).Methods Two thousand four hundred and thirty ACS patients admitted to First Affiliated Hospital of Xinjiang Medical University who underwent percutaneous coronary intervention(PCI)from February 2015 to February 2022 were selected as the study subjects.Patients were followed for up to December 1st,2023.MACE were a composite endpoint,the events of NCCLs were determined by coronary arteriography.To analyze the correlation of RC with NCCLs that did develop MACE,to assess the predictive value of RC and LDL-C on NCCLs that did develop MACE.Results The results of Spearman rank correlation analysis showed that RC was negatively correlated with age(rs=-0.30,P<0.001),and positively correlated with body mass index(BMI)(rs=0.43,P<0.001).Multivariable Cox regression analysis demonstrated that a larger RC(HR=1.72)were independently associated with subsequent MACE,for every 1 mmol/L increase in RC,and 1.72-fold higher risk of MACE.According to different RC level,Patients were divided into four groups and two groups.The Kaplan-Meier plane according to the high and low RC level,showing worser long-term clinical outcomes in patients in higher RC group,the patients who were the 0.50-0.99 mmol/L group had higher MACE and worser long-term clinical outcomes(HR=1.39)than RC<0.50 mmol/L group,the 1.00-1.49 mmol/L group(HR=2.34),and the≥1.50 mmol/L group(HR=2.89).The patients who were the RC≥30 mg/dl group had higher MACE and worser long-term clinical outcomes(HR=3.17)than RC<30 mg/dl group.Receiver operating characteristic(ROC)analysis was used to evaluate the predictive value of RC and LDL-C for NCCLs that did develop MACE,in ROC analysis,RC had an AUC of 0.660 and LDL-C had an AUC of 0.662.Conclusion RC is an independent risk factor for NCCLs that did develop MACE,for every 1 mmol/L increase in RC,and 1.72-fold higher risk of MACE.Patients with the higher RC level had a higher risk of all-cause MACE,and had a worser survival outcome,RC has a certain predictive value for NCCLs that did develop MACE.
Keywords：Remnant cholesterolAcute coronary syndromeNon-culprit coronary lesionsMajor adverse cardiovascular events
Publication Date：2025-07-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 584-589 )